Research looks at the use of medicines in Part D’s specialty tier

Phrma: 7/3/13

According to new research by Milliman, a leading actuarial consulting firm, only about 3.3 percent of Part D enrollees filled a prescription for at least one specialty drug in 2011, a very small portion of total Part D enrollment.

Only a small percentage of all Medicare enrollees fill prescriptions for specialty drugs, and corresponding spending is slight compared with spending on non-specialty drugs or especially hospital and physician services—the two highest sources of spending in Medicare. Part D specialty drugs costs in 2012 were about $31 per member per month (PMPM) for elderly, non-dually eligible beneficiaries. In contrast, spending on non-specialty drugs in Part D amounted to $248 PMPM, while spending on hospital and physician services was $507 PMPM and $321 PMPM, respectively. These numbers mean that specialty tier medicines are used by a small number of patients and represent only a small fraction of overall spending on both medicines and other types of health care services. They’re also a tremendous value for patients in the fight against disease. Read more